[Classical heatstroke in Spain. Analysis of a series 78 cases]

Seventy-eight cases of classical heat stroke (HS) seen during the summer of 1988 and 1989 have been evaluated. The diagnosis was established on the basis of classically accepted criteria (severe hyperthermia, impairment of the level of consciousness, anhydrosis, exposure to high environmental temperature). 62.8% of patients were females, with a mean age of 75 +/- 12.3 years. All patients had predisposing factors and 57.7% was taking facilitating drugs. 86% of the patients had 2 or more predisposing or facilitating factors. In 45 cases there were prodromic features. The suspicion of HS was not raised in any of the referring services. Hyperglycemia was present in 89.7% of cases, increased blood urea in 85.9%, high creatine kinase in 74.3%, abnormal coagulation in 52.9%, hypernatremia in 46.2%, hyponatremia in 37.2%, hypokalemia in 35.9%, hyperkalemia in 23.1%, metabolic acidosis in 41.1% and respiratory alkalosis in 36.9%. Electrocardiogram was abnormal in 95.4%. 31 patients (39.7%) died. Death was more common in patients with deep coma, shock, and higher blood urea levels. The present study demonstrates the occurrence of this condition in our area.